Aerospace Medicine: The Final Frontier for PAs?

Randall L. Owen, MEng, MSHS, PA-C, CST, has gone where few physician assistants have gone before—NASA. In April of this year, just weeks before graduating from The George Washington University PA program, he became the first PA student to complete a four-week clerkship in aerospace medicine at NASA’s Johnson Space Center (JSC) in Houston, Texas. The clerkship gives six students in their fourth year of medical school, or residency, the opportunity to work on a project, attend lectures and become familiar with the medical aspects of International Space Station (ISS) operations, design and function.

He is also the first PA to be offered a spot in the “Principles of Aviation and Space Medicine” course given each summer at the University of Texas Medical Branch in Galveston, Texas.

After receiving his bachelor’s degree in physics, Owen planned to go to medical school, but starting a family sent him in a different direction. After working for 25 years working in engineering and information technology, he realized it was time for a change.It was a chance to finally get into medicine. He enrolled in a full-time, one-year course to become a certified surgical technologist while simultaneously taking prerequisite courses for PA school at night. “When the time came for me to decide what to do next,” he says, “there was no question in my mind: I wanted to become a PA.”

Owen brought a wealth of unique experience to his PA training including advanced degrees in electrical and mechanical engineering as well as four years as an adjunct professor in computer science. Along the way, he worked for Hughes Aircraft, StorageTek (now a subsidiary of Oracle), Cisco, IBM and Amgen. This background, while atypical for PAs, was very similar to that of NASA flight surgeons and astronauts.

“NASA is fundamentally an engineering organization,” he says, “and I think when they looked at my resume they saw a guy with 20-plus years of engineering experience as well as significant midlevel medical training.”

While a few astronauts are trained physicians, all astronauts receive basic medical training to assist a crew member in an emergency medical event. Plus, approximately 65 percent of the research conducted aboard the ISS is medical or life science related.

Participants in the aerospace medicine clerkship are required to complete a research project based on an area of space medicine. Owen focused his research on entry motion sickness (EMS), which astronauts often experience when returning from the microgravity environment of space to Earth’s one G-force atmosphere. EMS can produce an array of debilitating symptoms including dizziness, nausea, headache, fatigue, reduced muscle strength, impaired coordination, and even changes in vision and the size of an astronaut’s heart as it adjusts to the pull of gravity.

The longer astronauts are away from Earth’s gravitational field, the longer it takes for them to return to normal. Owen’s research found that “for three-to-six-month missions, the EMS symptoms seem to require a minimum of a few days to up to 30 days to fully resolve.” He explains that “EMS will become an even greater concern when we start going off on longer-duration missions to other bodies, whether it’s the moon or Mars or some other distant place. Once astronauts arrive, they will have limited medical resources available to them so we need to be sure they can remain healthy and complete the mission.”

“When the time came for me to decide what to do next, there was no question in my mind: I wanted to become a PA.”

While he may not realize his ultimate dream of becoming the first PA in space, Owen has realized his dream of practicing aerospace medicine: He recently accepted a position as a medical operations specialist with NASA working in JSC space flight operations. His responsibilities will include performing duties as the lead for space medicine training for assigned ISS expeditions, training astronauts and flight controllers on various medical procedures, working in the Houston Mission Control Center guiding the astronauts in performing in-flight medical procedures (such as phlebotomy, ocular health or ultrasound), supporting EVAs as a medical monitor (e.g., vital signs, electrocardiograms), and serving as the subject matter expert (SME) for all space medicine remote guidance activities.

In addition to his aerospace medicine clerkship, Owen’s broad-based PA training included clerkships in surgery, OB/GYN, psychiatry, internal medicine, neurosurgery, emergency medicine, primary care and pediatrics. He is quick to encourage practicing PAs and students that “if there’s an area of medicine where PAs haven’t historically practiced, or if there’s an area that you’re interested in, research as much as you can and go for it. I ran into obstacles along the way, but it’s like anything in life: It’s a question of desire and perseverance. Set a goal and stay focused.”